Module 1 Exam Review Flashcards
Cultural Competence
is the ability to apply knowledge and skills need to provide high quality, evidence based practice care to clients of diverse backgrounds and beliefs to overcome barriers and access resources promoting health and wellness
Basic characteristics of cultural competence
- valuing diversity
- capacity for cultural self-assessment
- awareness of different dynamics present when cultures interact
- knowledge about different cultures
- adaptability in providing nursing care that reflects an understanding of cultural diversity
AACN’s 5 competencies for providing culturally competent care
- apply knowledge of social and cultural factors that affect nursing and health care across multiple contexts
- use relevant data sources and best evidence
- promote achievement of safe and quality outcomes of care for diverse populations
- advocate for social justice
- participate in continuous cultural competence development
LEARN Model (American Medical Student Association)
- Used as a tool for developing cultural competency
- LISTEN to the client’s perception of the problem
- EXPLAIN your perception of the problem and of the treatment ordered by the physicians
- ACKNOWLEDGE and discuss the differences/similarities between both perceptions
- REVIEW ordered treatments while remembering the client’s cultural parameters
- NEGOTIATE agreement. Assist the client in understanding the medical treatments ordered by the physician and have the client help make decisions about those treatments as appropriate
Purnell’s model of cultural competence
-identifies how individuals, families, communities, and the global society all possess 12 domains of culture:
- overview, inhabited localities, topography
- communication
- family roles/organization
- workforce issues
- biocultural ecology
- high risk behaviors
- nutrition
- pregnancy/childbearing practices
- death rituals
- spirituality
- healthcare practices
- healthcare practitioners
Prejudices
prejudgments about cultural groups or vulnerable populations that are unfavorable or false because they have been formed without background knowledge and context upon which to form an accurate opinion
Using an interpreter
- many clients do not speak english
- having bilingual nurses available is one strategy to a address the language barrier
- when possible, use an interpreter to translate and provide meaning behind the words
- avoid using a family member as an interpreter
- if possible, use an interpreter of the same gender as the client
- avoid medical jargon
- address your questions to the client, not the interpreter
- as one short question at a time
- speak slowly and distinctly, but not loudly
- provide written materials in the client’s language if possible
Terms and Language: Culturally sensitive
- possession of basic knowledge
- constructive attitudes towards diversity
Terms and Language: Culturally appropriate
- application of underlying background knowledge
- knowledge must be possessed to provide best care
Terms and Language: Culturally competent
attend the total context of the individuals situation
Terms and Language: Discrimination
restriction of justice, rights, privileges when dominant groups reinforce rules that limit opportunities for others
Terms and Language: Minority
individuals or group who are outside of dominant group
Terms and Language: Multiculturalism
many subcultures coexisting within a given society
Terms and Language: ethnic groups
individuals with common characteristics (nationality, language)
Terms and Language: Enculturation
cultural transmission from adults to children
Terms and Language: Assimilation
adapting to and integrating characteristics of dominant culture
Terms and Language: Acculturation
accepting the majority group’s culture as ones own
Terms and Language: biculturalism
dual pattern of identification (take what you consider the best of both cultures)
How do we, as future nurses, become culturally competent?
- Develop cultural humility
- Recognize your own biases (first, know thyself!)
- Value diversity
- Become knowledgeable about different cultures
- Acknowledge differences without stereotyping
- Be culturally sensitive
- Apply your knowledge
- Improve communication
- Access resources which promote health and wellness
12 Standards for culturally competent nursing care
- Social Justice
- Critical Reflection
- Knowledge of cultures
- Culturally competent practice
- Cultural competence in health care systems and organizations
- Client advocacy and empowerment
- Multicultural Workforce
- Education and training in culturally competent care
- Cross-cultural Communication
- Cross-cultural Leadership
- Policy Development
- Evidence-based practice and research
Complementary therapies
refers to any of a diverse array of practices, therapies, and supplements that are not considered part of conventional or traditional medicine
-used in addition to conventional medicine
Alternative therapies
use of these diverse therapies instead of conventional therapies
Touch
- americans can use touch during conversation between intimate partners or family members
- italian and latin americans can view frequent touch as a sign of cancer, interest, and warmth
- native americans view touch as a form of aggression
Vulnerable Populations
- Groups of people in our culture who are at greater risk for diseases and reduced lifespan due to lack of resources and exposure to more risk factors
- Clients from vulnerable populations are more likely to develop health problems because they have the greatest number if risk factors and the fewest options for managing those risk.
-likely to be older, living in poverty, homeless, in abusive relationships, mentally ill, chronically ill, or children
People may be made vulnerable by:
- Financial circumstance
- Place of residence
- Education
- Age
- Functional status
- Development status
- Inability to communicate
- Chronic or terminal illness
- Disability
- Sexual Orientation
- Immigration status
- Prisoners
Spirituality
the human experience that seeks to transcend self and find meaning and purpose through a connection with others, nature, and/or a Supreme Being
-also highly subjective
Religion
organized, communal approach to spirituality
Cues to spiritual or religious preference may be revealed by:
-environment, behavior, verbalization, affect and attitude, interpersonal relationships
Assessment of client
- Faith/beliefs
- Perception of life and self-responsibility
- Satisfaction with life
- Culture
- Fellowship and the client’s perceived place in the community
- Rituals and practices
- Incorporation of spirituality within profession or workplace
- Client expectations for health care in relation to spirituality (Traditional vs. Alternative paths, such as shamans, priests, prayer)
FICA is an acronym that can help a nurse to ask appropriate spirituality questions
F- Faith or beliefs
EX: What spiritual beliefs are most important to you?
I- Implications or influence
EX: How is your faith affecting the way you cope now?
C- Community
EX: Is there a group of like-minded believers with whom you regularly meet?
A- Address
EX: How would you like your health care team to support you spiritually?
Holy Days
- days set aside for religious observances
- may require fasting, extended prayer
- sabbath
- high holy day
Spiritual Rituals
holy days, birth rituals, prayer, death rituals, dietary rituals
Birth Rituals: Buddhism
- Can refuse on holy days
- Can refuse analgesics or strong sedatives
Birth Rituals: Christianity
some baptize infants at birth
Birth Rituals: Hinduism
- do not prolong life
- personal hygiene and cleanliness are valued
Birth Rituals: Islam
- Women must be cared for by female providers, especially during childbirth
- Women often must wear head and/or body covering when in the presence of males who are not immediate family
- Have strict rules regarding hand washing
- Must pray five times a day facing mecca
Rituals: Jehovah’s witnesses
Might not accept blood transfusions, even in life threatening situations
Birth Rituals: Judaism
on the eighth day after birth, males are circumcised
Birth Rituals: mormonism
children are baptized at age 8 by immersion
Spiritual health
spiritual health or spiritual well-being is manifested by a feeling of being “generally alive, purposeful, and fulfilled”
Individuals nurture their spiritual health in many ways:
- development of inner self (inner dialogue with a higher power through prayer, meditation, etc…)
- focus on the outer world
Transcendent presence
- transcendence is the capacity to reach out beyond oneself, to extend oneself beyond personal concerns and to take on broader life perspectives, activities, and purposes
- involves an individual’s recognition that there is something other or greater than self
Spiritually Appropriate Nursing Care
- assess the patient’s spiritual needs
- support the patient’s religious practices and consider how these practices may affect nursing care
- help the patient continue with spiritual practices
- assist patients with prayer
- religion and medical care